Contents -- Symbols and abbreviations -- 1 Sexual differentiation -- Key stages of fetal sex differentiation -- The SRY gene -- Other genes involved in sex determination -- Abnormal embryological development-intersex conditions -- Hermaphroditism -- Mullerian anomalies -- Hand-foot-genital syndrome -- Incomplete regression of the Wolffian system -- Further information -- 2 Steroid hormones -- Introduction -- Steroid hormone biosynthesis reactions -- Gonadal steroid hormones -- Steroid-binding proteins -- Further reading -- 3 Menarche and adolescent gynaecology -- Introduction -- Hypothalamic-pituitary-gonadal axis -- Stages of puberty -- Precocious puberty -- Delayed puberty -- Further reading -- 4 Ovaries and the menstrual cycle -- Introduction -- Hormones -- The ovary -- Follicular development -- Causes of anovulation and oligo-ovulation -- 5 Polycystic ovary syndrome -- Introduction -- Definition -- Prevalence -- Aetiology -- Pathophysiology -- Management -- Long-term health implications of PCOS -- Further reading -- 6 Hirsutism and virilization -- Introduction -- Pathophysiology -- History and examination -- Aetiology -- Differential diagnosis -- Treatment -- 7 Amenorrhoea and oligomenorrhoea -- Introduction -- Aetiology -- Investigations -- Management -- 8 Menopause and hormone replacement therapy -- Introduction -- Pathophysiology -- Other hormonal changes -- Symptoms -- 'Women's Health Initiative (WHI) trial' and 'Million Women Study' -- UK Committee on the Safety of Medicines and HRT -- HRT preparations -- Alternative treatment -- Further reading and information -- 9 Initial advice to those concerned about delays in conception -- Prevalence of fertility problems -- Timing of the initial investigation -- Female partner's age -- Frequency and timing of intercourse -- Environmental and dietary influences -- 10 Defining infertility.

Introduction -- General points before starting investigation -- 11 Investigation of fertility problems -- Introduction -- Investigation of the male partner -- Investigation of the female partner -- Investigation of a possible mechanical factor -- Further reading -- 12 Management strategies for fertility problems -- Principles -- Management of investigations -- Management strategies -- 13 Male infertility -- Introduction -- Aetiology -- Investigation of the male -- Further reading and information -- 14 Ovulation induction -- Introduction -- Clomifene citrate -- Aromatase inhibitors -- Metformin -- Pulsatile gonadotrophin-releasing hormone -- Gonadotrophins -- Laparoscopic ovarian drilling (LOD) -- Further reading -- 15 Tubal and uterine disorders -- Introduction -- Tubal disorders -- Surgery to the fallopian tube -- Uterine disorders -- 16 Medical and surgical management of endometriosis -- Introduction -- Examination and investigations -- Endometriosis-associated infertility -- Surgical treatment of endometriosis -- NICE Guidelines (2004) -- Medical treatment -- Further reading and information -- 17 Intra-uterine insemination -- Introduction -- Methods -- Principle -- Indications -- IUI for mild male factor infertility -- IUI for unexplained infertility -- Cost-effectiveness -- Conclusions -- Further reading -- 18 In vitro fertilization and associated assisted conception techniques -- Introduction -- Factors affecting the outcome of IVF -- Number of embryos transferred -- Regulation of IVF -- Procedures used during IVF -- Intracytoplasmic sperm injection -- Oocyte donation -- Complications of IVF -- Follow-up of children born as a result of assisted reproduction -- Further reading and information -- 19 Fertility and fertility awareness -- Introduction -- Sex and Relationships Education (SRE) -- Patients under 16 years of age (age of consent).

Sexually transmitted infections -- Features of the ideal contraceptive -- Relative effectiveness of the available methods -- Eligibility criteria for contraceptives -- Fertility awareness and methods for the natural regulation of fertility -- 20 Male contraception -- Coitus interruptus -- Male condoms -- The male Pill -- Vasectomy -- 21 Vaginal methods -- Female condoms -- Caps and diaphragms -- Spermicide (nonoxinol) -- 22 The combined oral contraceptive (COC) -- Mechanism of action -- Benefits versus risks -- Tumour risk and COCs -- Cardiovascular disease -- Eligibility criteria for COCs -- The pill-free interval (PFI) -- Drug interactions -- Other relevant drugs -- Counselling and ongoing supervision -- Stopping COCs -- Pill follow-up -- Congenital abnormalities and fertility issues -- Other combined methods -- 23 Progestogen-only pill (POP) -- Introduction -- Mechanism of action and maintenance of effectiveness -- Risks and disadvantages -- Advantages and indications -- Problems and contraindications -- Counselling and ongoing supervision -- Cerazette® -- 24 Injectables -- Introduction -- Mechanism of action and effectiveness -- Indications -- Advantages -- Problems and disadvantages -- Contraindications -- Counselling and ongoing supervision -- 25 Contraceptive implants -- Introduction -- Mechanism of action, administration and effectiveness -- Enzyme inducer drug (EID) treatment -- Reversibility and removal problems -- Indications -- Advantages -- Disadvantages and contraindications -- Counselling and ongoing supervision -- 26 Intra-uterine contraception -- Introduction -- Copper-bearing devices -- The levonorgestrel-releasing intra-uterine system (LNG-IUS) -- 27 Postcoital contraception -- Introduction -- Levonorgestrel emergency contraception (LNG EC) -- Copper intrauterine devices (IUDs) -- Counselling and management.

Special indications for EC -- 28 Sterilization -- Introduction -- Efficacy considerations -- Potential reversibility -- Possible long-term side-effects of female sterilization -- Comparison of methods -- 29 Special considerations -- How can a provider be reasonably sure of a woman not being pregnant -- Contraception at the climacteric -- 30 Appendix -- Use of licensed products in an unlicensed way -- Essential websites in reproductive health -- Further reading and references -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M -- N -- O -- P -- Q -- R -- S -- T -- U -- V -- W -- Y -- Z.